Penetrating neck trauma: a 5-year review of the literature, 1983 to 1988.

Penetrating neck trauma remains controversial: some trauma centers continue to pursue a policy of mandatory exploration while others advocate selective exploration. The literature regarding penetrating neck trauma published during the past 5 years is reviewed in this report. The majority of reports support selective exploration, and most civilian centers report a mortality of 3% to 6% regardless of the type of exploration performed. To clarify the rationale behind the selective management of penetrating neck wounds, current data on ballistics, ancillary diagnostic studies, and comparative costs are reviewed. Emergency room management and surgical follow-up, which vary according to the type of missile and the zone of the neck penetrated, are discussed.